It takes an average of 24 days to schedule a new patient physician appointment in 15 of the largest cities in the nation, up from 18.5 days in 2014.
Despite Boston's dense concentration of physicians, it takes more than twice as long the average national waiting time to schedule a new patient appointment, according to a new survey from physician recruiters Merritt Hawkins.
The 2017 Survey of Physician Appointment Wait Times and Medicare and Medicaid Acceptance Rates queried 1,414 physicians' offices in 15 major metro markets across the nation and found that Boston's average wait time of 52 days was the longest for five medical specialties, including:
- 109 days to see a family physician
- 52 days to see a dermatologist
- 45 days to see an obstetrician/gynecologist
- 45 days to see a cardiologist
- 11 days to see an orthopedic surgeon
James S. Gessner, MD, president of the Massachusetts Medical Society, says the Merritt Hawkins findings are consistent with MMS's in-house physician workforce studies.
"We've always had rather long wait times, but we also have universal healthcare with 97% of the citizens in this state covered by health insurance," Gessner says. "I can only expect that it might get a little pronounced at this point."
The Nursing Shortage? It's Complicated
Gessner says that more medical students are gravitating toward primary care, but that the wait times probably won't decrease anytime soon because there is a "pipeline issue."
"It takes five or six years for those people to appear on the scene," he says. "We are expanding the primary care residencies at a number of our teaching hospitals and that is a very good sign, but we still would have significant shortages in the other specialties with significant waits as well."
Gessner says other more immediate strategies to alleviate wait times include the use of nurse practitioners and physician assistants in a "team-based care" model, and telemedicine.
Boston has a lot of physicians, but many are not clinicians.
"Boston is the Silicon Valley for biotechnology and research. While we have a number of physicians here in Massachusetts and on our rolls in the medical society, there are significant number who have very limited clinical engagement with patients," Gessner says. "They're doing research, or teaching, and there are a large number who are in entrepreneurial businesses and aren't seeing patients at all."
Boston is Not Alone
The survey shows that it takes an average of 24 days to schedule a new patient physician appointment in 15 of the largest cities, up from 18.5 days in 2014, 20.5 days in 2009 and 21 days in 2004, the previous years that Dallas-based Merritt Hawkins conducted the survey.
"Physician appointment wait times are the longest they have been since we began conducting the survey," said Mark Smith, president of Merritt Hawkins. "Growing physician appointment wait times are a significant indicator that the nation is experiencing a shortage of physicians."
Dallas has the shortest average physician appointment wait times of the 15 metro markets at 15 days. Average physician appointment wait times in other cities tracked by the survey include:
- 37 days in Philadelphia
- 28 days in Portland
- 28 days in Seattle
- 27 days in Denver
- 24 days in Los Angeles
Wait times are even longer outside of major metro areas, where the physician-to-population ratio generally is not as high as in major markets. For the first time, the survey this year examined new patient wait times in 15 mid-sized cities of approximately 90,000 to 140,000 people and found the average is 32 days, which is 33% longer than in the major metro markets.
Yakima, Washington has the longest average physician appointment wait times of the 15 mid-sized cities at 49 days while Billings, Montana has the shortest at 11 days.
"Finding a physician who can see you today, or three weeks from today, can be a challenge, even in large urban areas where there is a relatively robust supply of doctors," said Smith. "The challenge becomes even more difficult in smaller communities that have fewer physicians per population."
Medicare/Medicaid Acceptance Rates
The survey found that the average rate of physician Medicare acceptance is 85% in the 15 large metro markets and 81% in the 15 mid-sized markets. The average rate of physician Medicaid acceptance is 53% in the large metro markets and 60% in the mid-sized markets.
Smith said the survey shows that physician supply and accessibility will need to be enhanced as the healthcare system continues to evolve.
"More physicians will need to be trained, access to other types of providers expanded, and emerging technologies employed to ensure that health care delayed does not become health care denied," Smith said.
AAMC Projects Physician Shortfall
The survey findings fall in line with a report issued this month by the Association of American Medical Colleges, which shows a projected shortage of between 40,800 and 104,900 doctors by 2030.
"The nation continues to face a significant physician shortage. As our patient population continues to grow and age, we must begin to train more doctors if we wish to meet the health care needs of all Americans," AAMC President and CEO Darrell G. Kirch, MD, said in remarks accompanying the report.
By 2030, the study estimates a shortfall of between 7,300 and 43,100 primary care physicians. Non-primary care specialties are expected to experience a shortfall of between 33,500 and 61,800 physicians.
"By 2030, the U.S. population of Americans aged 65 and older will grow by 55 percent, which makes the projected shortage especially troubling," Kirch said. "As patients get older, they need two to three times as many services, mostly in specialty care, which is where the shortages are particularly severe."
Gessner says some effort should be made to find attractive career pathways for physicians who aren't now actively practicing medicine.
"Perhaps part-time practice is an option for people who want to restrict their practice while they're raising a family or for other social considerations that we need to discuss, think about and accommodate," he says.
"There are a lot of different reasons for these wait times, but there are also a large number of potential solutions; some off of technology and some off of work/lifestyle changes. We always need to engage more people in the profession."
John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.